Monitoring of the critically ill patient with acute heart failure still remains a special challenge for intensive care physicians. A rapid change of the patients' condition is subject to the underlying disease and even cardiac arrest may occur without preliminary warnings. The continuous monitoring of heart rate and rhythm, as well as noninvasive measurement of blood pressure, body temperature and urine elimination are obligatory components of the so-called standard monitoring. In addition, the modular concepts of the present-day monitoring systems become endorsed by techniques such as twelve-lead electrocardiogram and the obligatory echocardiography. Moreover, determination of biochemical markers depends on the clinical problem. The indications for invasive cardiovascular hemodynamic monitoring with pulmonary artery catheter or with less invasive techniques--such as pulse contour analysis or thermal dye dilution technique--must be placed critically. There is no evidence at all that prognosis is changed by implementation of a monitoring technique.